What are measles?

Measles (red measles) is a severe illness caused by a virus and is very contagious. It usually occurs in young children, but anyone who is not protected can be infected with measles. Most people recover from infection, but measles can have serious complications and lead to long-term health problems. Since the widespread use of the measles vaccine, measles is very rare. Over the past five years, there has been an average of 10 measles cases each year in Canada.

How do you get measles?

Measles is spread when a person comes in contact with an infected person. It’s spread through tiny drops that are released into the air when an infected person coughs, sneezes, or talks. Measles is one of the easiest viruses to spread from person to person. Unlike the flu virus, the measles virus can’t survive for very long on objects like doorknobs and telephones.

If you or your child has measles then you must limit contact with others as much as possible , which includes staying home from work or school. This will help protect them from infection.

What are the symptoms?

It’s important to detect measles as soon as possible, since the disease is contagious at an early stage. An infected person is contagious one day before symptoms start until four days after the rash appears. Measles symptoms appear in two stages.
First stage symptoms:
• Runny nose
• Cough
• Red and watery eyes that are sensitive to light
• Slight fever

Second stage symptoms:
• Starts three to seven days after first symptoms
• High fever (as high as 40°C or 104°F)
• Red rash, first on the face and then moving down the body, legs, and arms

Another symptom of measles is the presence of small, red, irregular spots that develop on the inside of the cheeks, near the back teeth. Each spot will have a whitish or bluish centre. These spots are a sure sign of measles and appear about two days after first stage symptoms, which is about two days before the rash develops. The presence of these spots is usually enough for a doctor to make a diagnosis.

What are the complications?

People with measles may become quite ill, but most people recover completely. However, complications may include:

Ear infection. Measles causes an ear infection in nearly one out of every 10 children.

Encephalitis. About one in 1,000 people with measles develops encephalitis, an inflammation of the brain, which may cause vomiting, convulsions and, rarely, coma. Encephalitis can occur shortly after infection or it can occur years later during the teen years. This late form, called Dawson’s encephalitis, is rare.

Pneumonia. An infection that causes inflammation in the lungs. As many as one in 15 people with measles gets pneumonia, which can be life-threatening.

Diarrhea or vomiting. These complications are more common in infants and small children.

Bronchitis, laryngitis. Measles may lead to inflammation of your voice box (larynx) or inflammation of the inner walls that line the main air passageways of your lungs (bronchial tubes).

Pregnancy problems. Pregnant women need to take special care to avoid measles, because the disease can cause miscarriage, premature labor, or babies with low birth weights.

Who is at risk of getting measles?

Anyone who hasn’t had the disease or been immunized can get measles. Infants are most at risk because immunity passed from their mother at birth decreases after six months of age.

How is measles treated?

Like the common cold, measles is something that the body will fight off and will go away with time. There are no drugs that can kill the virus, so the only useful treatments are those that help relieve symptoms. For example, drugs like acetaminophen can reduce fever and other symptoms. However, supportive care in hospital may be needed for severe infections but most people infected with measles can recover at home.

Malnourished children in developing countries are often given large doses of vitamin A to shorten the length of the disease and reduce complications. In North America, very few children suffer from vitamin A deficiency, so it’s rarely used here.

If you think you have measles call your health care provider before going for your visit. The office can then prepare for your arrival so the infection is not passed on to others.

What can I do to prevent measles?

The best way to prevent the measles is to get a vaccine and to keep all your vaccinations up-to-date. The measles vaccine is commonly given in the same shot as the mumps and rubella vaccine, in what is commonly known as MMR. Two doses of measles/mumps/rubella (MMR) vaccine are recommended for children. One dose is given on or after the first birthday; the second dose should be given after 15 months of age but before school. A second dose of MMR vaccine is also recommended for Canadians at greatest risk of exposure, such as travellers to measles-endemic areas, health care workers, and students at post-secondary institutions. Speak to your health care provider regarding the status of your immunization. For mothers who’ve already had measles, their newborn babies are protected for about a year due to the transfer of special antibodies from the mother’s immune system. Because of this, the measles vaccine may not work in a child’s first year of life.

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References:

Heymann, D.L. (2004). Control of communicable diseases manual, 18th ed. Washington: American Public Health Association.